Peritonitis with small bowel perforation caused by a fish bone in a healthy patient

Abstract

Perforation of the gastrointestinal tract by ingested foreign bodies is extremely rare in otherwise healthy patients, accounting for < 1% of cases. Accidentally ingested foreign bodies could cause small bowel perforation through a hernia sac, Meckel's diverticulum, or the appendix, all of which are uncommon. Despite their sharp ends and elongated shape, bowel perforation caused by ingested fish bones is rarely reported, particularly in patients without intestinal disease. We report a case of 57-year-old female who visited the emergency room with periumbilical pain and no history of underlying intestinal disease or intra-abdominal surgery. Abdominal computed tomography and exploratory laparotomy revealed a small bowel micro-perforation with a 2.7-cm fish bone penetrating the jejunal wall.

Delay in diagnosis and lessons learnt from a case of abdominal wall abscess caused by fishbone perforation

“…Accidental ingestion of fishbone is not uncommon but despite the sharp ends, the majority pass through the gastrointestinal tract uneventfully and perforation is rare. 1 They may on occasion, however, present in various ways from upper gastrointestinal impaction, dysphagia, bowel obstruction or silent perforation to frank peritonitis. The clinical history may not be helpful, and establishing the cause is difficult because the episode of swallowing the bone frequently goes unnoticed and may have occurred several days or weeks previously.…”

“…3 Most of these cases were described in fish eating countries (eg China) and no such cases have been reported in the UK. 1 Bhatia et al reported a case of terminal ileal perforation in an 85-year-old patient due to fish fin ingestion. 4 The patient was initially managed conservatively and, owing to worsening sepsis, needed laparotomy and terminal ileal enterotomy with removal of the offending FB.…”

“…FBs such as fishbones, chicken bones and toothpicks have been reported to cause gastrointestinal perforation following ingestion. 1 These perforations can present either as an acute abdomen or later as an intra-abdominal collection. We present a case of anterior abdominal wall abscess caused by fishbone perforation.…”

Successfully Treated Intra-Abdominal Abscess Caused by Fish Bone With Perforation of Ascending Colon: A Case Report

“…3 Bones from sebastes, cod, sea bream, and eels are reported most often, [8][9][10][11] and these species are eaten in both Asian and European countries. In our case, the patient remembered eating fried sebastes 8 weeks earlier.…”

Modern opportunities of early diagnostics and minimally invasive surgical treatment of intestinal perforation by a foreign body

“…Одной из причин перфорации полых органов живота является попадание в просвет желудочно-кишечного тракта (ЖКТ) различных инородных тел (ИТ). По сведениям ряда авторов, этот вид перфорации встречается в практике хирурга крайне редко и чаще возникает у пациентов с грыженосительством или меккелевым дивертикулом [1,2].…”